An overview of prognostic factors for long-term survivors of breast cancer

Abstract

Background Numerous studies have examined prognostic factors for survival of breast cancer patients, but relatively few have dealt specifically with 10+-year survivors. Methods A review of the PubMed database from 1995 to 2006 was undertaken with the following inclusion criteria: median/mean follow-up time at least 10 years; overall survival and/or disease-specific survival known; and relative risk and statistical probability values reported. In addition, we used data from the long-standing Eindhoven Cancer Registry to illustrate survival probability as indicated by various prognostic factors.Results 10-year breast cancer survivors showed 90% 5-year relative survival. Tumor size, nodal status and grade remained the most important prognostic factors for longterm survival, although their role decreased over time. Most studies agreed on the long-term prognostic values of MI (mitotic index), LVI (lymphovascular invasion), Her2-positivity, gene profiling and comorbidity for either all or a subgroup of breast cancer patients (node-positive or negative). The roles of age, socioeconomic status, histological type, BRCA and p53 mutation were mixed, often decreasing after correction for stronger prognosticators, thus limiting their clinical value. Local and regional recurrence, metastases and second cancer may substantially impair long-term survival. Healthy lifestyle was consistently related to lower overall mortality. Conclusions Effects of traditional prognostic factors persist in the long term and more recent factors need further follow-up. The prognosis for breast cancer patients who have survived at least 10 years is favourable and increases over time. Improved long-term survival can be achieved by earlier detection, more effective modern therapy and healthier lifestyle.

Targeting Stat3 Induces Senescence in Tumor Cells and Elicits Prophylactic and Therapeutic Immune Responses against Breast Cancer Growth Mediated by NK Cells and CD4+ T Cells

“…Interestingly, tumors obtained from mice immunized with pcDNA3.1-transfected cancer cells had higher histological grades and tumor sizes than those from mice immunized with Stat3Y705F-transfected cancer cells. A 10-y follow-up of breast cancer patients showed that tumor size, nodal status, and tumor grade remained the most important prognostic factors for long-term survival (38) and were also predictors for distant metastasis (39). Importantly, we found that immunization with Stat3-inhibited breast cancer cells decreased tumor grade, tumor growth, and metastasis, the most important prognostic indicators in breast cancer.…”

Protein interacting with C α kinase 1 (PICK1) is involved in promoting tumor growth and correlates with poor prognosis of human breast cancer

“…(34,35) Tumor size, node status, historical grade, hormone receptors (HR), and Her-2 ⁄ neu status have been used with limited success as the biomarkers. (36)(37)(38)(39) Currently, breast cancer is commonly subclassified on the basis of the presence of ER, PR, and the HER-2 ⁄ neu status. Breast cancers can be divided into HR + ⁄ HER-2 ) , HR + ⁄ HER-2 + , HR ) ⁄ HER-2 + , and HR ) ⁄ HER-2 ) (triple-negative).…”

Disease-free survival in patients with non-metastatic breast cancer

“…[6][7][8] Early diagnosis associated with treatment could reduce the mortality of the disease. [8][9][10][11][12] Disease-free survival (DFS) is defined as the time between the beginning of the treatment and disease progression or death from any cause. [13][14][15] Factors related to a shorter DFS include tumors larger than 2 cm, the presence of lymph node involvement and more advanced stages of the disease.…”